scholarly journals Sleep promotion for hospitalised children: Developing an evidence-based guideline for nurses

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Elijeshca C. Crous ◽  
Natasha North
Keyword(s):  
South African ◽  
Clinical Care ◽  
Evidence Base ◽  
Poor Sleep ◽  
Healthcare Team ◽  
Hospital Nurses ◽  
Evidence Based ◽  
The South ◽  
Guideline Adaptation ◽  
Evidence Based Guideline

Background: Adequate sleep in hospitalised children is important for a variety of physiological and psychological processes associated with growth, development, and recovery from illness and injury. Hospitalisation often prioritises clinical care activities at the expense of age-appropriate sleep. Nurses and the wider healthcare team contribute to this paradox. However, through conscious practice and partnering with mothers, nurses are able to enact change and promote sleep.Objectives: To adopt, adapt or contextualise existing guidelines to develop an evidence-based practice guideline to promote sleep-friendly ward environments and routines facilitated by nurses, and in partnership with mothers.Method: A six-step methodology for guideline adaptation was followed, as recommended by the South African Guidelines Excellence project: (1) existing guidelines and protocols were identified and (2) appraised using the AGREE II instrument; (3) an evidence base was developed; (4) recommendations were modified, (5) assigned levels of evidence and grades of recommendation; and (6) end user guidance was developed. Expert consultation was sought throughout.Results: Existing relevant guidance comprised 61 adult-centric recommendations. Modification of the evidence base led to six composited recommendations that facilitate sleep in hospitalised children: (1) prioritising patient safety; (2) collaborating with the mother or caregiver to promote sleep; (3) coordinating ward routine and (4) environment to improve sleep; (5) work with clinical and non-clinical staff; and (6) performing basic sleep assessments. Practice recommendations were aligned to the South African regulatory framework for nursing.Conclusion: Hospitalisation is a time of physiological and psychological dysregulation for children, which is amplified by poor sleep in a hospital. Nurses have the opportunity to promote sleep during hospitalisation by implementing this African-centric guideline in partnership with mothers.

scholarly journals Role of the nurses in partnering with mothers to give oral medication to their hospitalised child: Modification and development of a contextualised evidence-based practice guideline

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Nadia Harris ◽  
Andrea Amos ◽  
Natasha North
Keyword(s):  
South African ◽  
Practice Guideline ◽  
Evidence Based Practice ◽  
Oral Medication ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Policy Document ◽  
Regulatory Frameworks ◽  
Guideline Adaptation ◽  
Evidence Based Guideline

Background: In paediatric wards, children are often reluctant to receive medication from nurses and eventually it is given by the parents. It is a common practice for nurses to hand the medication to mothers to give to their children, However, it is an ‘informal’ practice and lacks evidence-based guidelines.Objectives: To develop a contextualised and adapted evidence-based guideline to support nurses to partner with mothers/carers so that they can safely give oral medication to their hospitalised child under the supervision of a competent nurse.Method: Existing relevant guidelines were identified through searches of bibliographic databases and websites. The AGREE II: Appraisal of Guidelines for Research and Evaluation II instrument was used to appraise the quality of the identified sources. The process of guideline adaptation recommended by the South African Guidelines Excellence project was followed, and a list of adapted recommendations was developed, aligned with the legislative and regulatory frameworks for nursing in South Africa. Accessible end user documentation was developed.Results: Six sources were screened and three sources were found to be eligible and were subjected to full appraisal. Two guidelines and one policy document were identified as suitable for adaptation. Expert consultation confirmed that the resulting adapted guideline was sound, easy to understand, and well presented for the target audience.Conclusion: This process successfully led to the development of a modified evidence-based practice guideline to enable nurses to partner with mothers/caregivers in safely giving oral medication to their hospitalised child in lower-resourced African settings.

scholarly journals Management of obesity in Scotland: development of the latest evidence-based recommendations

2010 ◽  
Vol 69 (2) ◽  
pp. 195-198 ◽  
Author(s):  
J. Thompson
Keyword(s):  
Young People ◽  
Clinical Excellence ◽  
Evidence Base ◽  
Evidence Based ◽  
Healthy Weight ◽  
Guideline Adaptation ◽  
Lifestyle Measures ◽  
Scottish Government ◽  
Clinical Conditions ◽  
The Cost

The problem of obesity in Scotland has reached epidemic proportions and this reality is recognised at Scottish Government level. The financial impact of treating obesity and obesity-related disease is substantial and in Scotland the cost was estimated at £171×106 in 2001 but only a small proportion of this estimate included weight-loss interventions. The Scottish Intercollegiate Guidelines Network (SIGN) define clinical guidelines as ‘systematically developed statements to help practitioner and patient decisions’ that ‘provide recommendations for effective practice in the management of clinical conditions where variations in practice are known to occur and where effective care may be known not to occur’. The evidence base for successful interventions has progressed since the publication by SIGN of Obesity in Scotland: Integrating Prevention with Weight Management in 1996 and Management of Obesity in Children and Young People in 2003. In 2007 SIGN commissioned a review of these two publications. In 2006 the National Institute for Health and Clinical Excellence (NICE) published a comprehensive obesity guideline and to avoid duplication of effort SIGN used the ADAPTE guideline adaptation framework to utilise and update evidence tables produced by NICE (where appropriate) as a basis for considered judgement. The new SIGN guideline is due for publication in 2010 and addresses children, young people (<18 years old) and adults. It will provide evidence-based recommendations on primary prevention of obesity (defined as intervention when individuals are at a healthy weight and/or overweight to prevent or delay the onset of obesity) within the clinical setting and treatment by lifestyle measures, drugs and surgery.

scholarly journals Corporations’ use and misuse of evidence to influence health policy: a case study of sugar-sweetened beverage taxation

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Gary Jonas Fooks ◽  
Simon Williams ◽  
Graham Box ◽  
Gary Sacks
Keyword(s):  
South African ◽  
Evidence Base ◽  
Evidence Based ◽  
Economic Modelling ◽  
Complex Interplay ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Sweetened Beverages ◽  
The Impact

Abstract Background Sugar sweetened beverages (SSB) are a major source of sugar in the diet. Although trends in consumption vary across regions, in many countries, particularly LMICs, their consumption continues to increase. In response, a growing number of governments have introduced a tax on SSBs. SSB manufacturers have opposed such taxes, disputing the role that SSBs play in diet-related diseases and the effectiveness of SSB taxation, and alleging major economic impacts. Given the importance of evidence to effective regulation of products harmful to human health, we scrutinised industry submissions to the South African government’s consultation on a proposed SSB tax and examined their use of evidence. Results Corporate submissions were underpinned by several strategies involving the misrepresentation of evidence. First, references were used in a misleading way, providing false support for key claims. Second, raw data, which represented a pliable, alternative evidence base to peer reviewed studies, was misused to dispute both the premise of targeting sugar for special attention and the impact of SSB taxes on SSB consumption. Third, purposively selected evidence was used in conjunction with other techniques, such as selective quoting from studies and omitting important qualifying information, to promote an alternative evidential narrative to that supported by the weight of peer-reviewed research. Fourth, a range of mutually enforcing techniques that inflated the effects of SSB taxation on jobs, public revenue generation, and gross domestic product, was used to exaggerate the economic impact of the tax. This “hyperbolic accounting” included rounding up figures in original sources, double counting, and skipping steps in economic modelling. Conclusions Our research raises fundamental questions concerning the bona fides of industry information in the context of government efforts to combat diet-related diseases. The beverage industry’s claims against SSB taxation rest on a complex interplay of techniques, that appear to be grounded in evidence, but which do not observe widely accepted approaches to the use of either scientific or economic evidence. These techniques are similar, but not identical, to those used by tobacco companies and highlight the problems of introducing evidence-based policies aimed at managing the market environment for unhealthful commodities.

scholarly journals Trial Reporting in Immuno-Oncology (TRIO): An American Society of Clinical Oncology-Society for Immunotherapy of Cancer Statement

2019 ◽  
Vol 37 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Apostolia M. Tsimberidou ◽  
Laura A. Levit ◽  
Richard L. Schilsky ◽  
Steven D. Averbuch ◽  
Daniel Chen ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Care ◽  
Evidence Base ◽  
Rapid Expansion ◽  
Evidence Based ◽  
Medical Oncologists ◽  
Immunotherapy Of Cancer ◽  
American Society ◽  
Existing Data ◽  
Support Evidence

Purpose To develop recommendations for clinical trial reporting that address the unique efficacy, toxicity, and combination and sequencing aspects of immuno-oncology (IO) treatments. Methods ASCO and the Society for Immunotherapy of Cancer (SITC) convened a working group that consisted of practicing medical oncologists, immunologists, clinical researchers, biostatisticians, and representatives from industry and government to develop Trial Reporting in Immuno-Oncology (TRIO) recommendations. These recommendations are based on expert consensus, given that existing data to support evidence-based recommendations are limited. Conclusion The TRIO recommendations are intended to improve the reporting of IO clinical trials and thus provide more complete evidence on the relative benefits and risks of an IO therapeutic approach. Given the rapid expansion of the number of IO clinical trials and ongoing improvements to the evidence base supporting the use of IO treatments in clinical care, these recommendations will likely need regular revision as the IO field develops.

scholarly journals Evidence-based Clinical Nursing Practice Guideline for Management of Inpatient Falls: Adopting the Guideline Adaptation Process

2020 ◽  
Vol 27 (1) ◽  
pp. 40-51
Author(s):  
Insook Cho ◽  
Kyung Hee Park ◽  
Minhee Suh ◽  
Eun Man Kim
Keyword(s):  
Risk Factors ◽  
Preventive Intervention ◽  
Readiness For Change ◽  
Hospital Nurses ◽  
Evidence Based ◽  
Effective Prevention ◽  
Practice Nurses ◽  
Guideline Adaptation ◽  
Fall Rates ◽  
Improvement Programs

Purpose: Despite research efforts, current fall rates are still higher than expected. To approach this problem, we developed guidelines on preventing falls in hospitals.Methods: Four guidelines were selected by the K-AGREE II process. Recommendations from each guideline were retrieved and evaluated based on the quality of evidence and the strength of the recommendations. Recommendations followed the grading system of the Korean Hospital Nurses Association’s Guideline Adaptation Manual. In the external review, 13 practice nurses from 5 hospitals and 13 panel experts including doctors, nursing managers, and pharmacists participated.Results: The final guideline consisted of 5 sections and 341 recommendations. The first two sections were composed of recommendations for institutional readiness for change process and management, and Section 3 was divided into assessment of risk factors, preventive intervention and post-fall management. The summary of falls risk factors included seven components. Multifaceted interventions were modeled into six strategies. The final sections consisted of recommendations for implementing fall improvement programs and for sustaining effective prevention programs.Conclusion: Given that falls result from various combinations of risk factors, the present guideline contains multifaceted assessments and interventions including risk-targeted strategy. This guideline will contribute to decreasing fall rates in hospitals by stimulating compliance with evidence-based practice.

scholarly journals Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review

2016 ◽  
Vol 24 (e1) ◽  
pp. e207-e215 ◽  
Author(s):  
Minal R Patel ◽  
Jennifer Vichich ◽  
Ian Lang ◽  
Jessica Lin ◽  
Kai Zheng
Keyword(s):  
Systematic Review ◽  
Best Practices ◽  
Clinical Care ◽  
Strong Support ◽  
Evidence Base ◽  
Evidence Based ◽  
Patient Centered ◽  
Exam Room ◽  
Communication Practices ◽  
Electronic Health

Objective: The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill “best” behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. Methods: We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Results: Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. Discussion and Conclusion: We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care.

Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline

2019 ◽  
Vol 37 (14) ◽  
pp. 1228-1263 ◽  
Author(s):  
Joseph Mikhael ◽  
Nofisat Ismaila ◽  
Matthew C. Cheung ◽  
Caitlin Costello ◽  
Madhav V. Dhodapkar ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Literature Search ◽  
Expert Panel ◽  
Progression Free Survival ◽  
Evidence Base ◽  
Evidence Based ◽  
Phase Ii Studies ◽  
Meta Analyses ◽  
Evidence Based Guideline

PURPOSE To provide evidence-based recommendations on the treatment of multiple myeloma to practicing physicians and others. METHODS ASCO and Cancer Care Ontario convened an Expert Panel of medical oncology, surgery, radiation oncology, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and some phase II studies published from 2005 through 2018. Outcomes of interest included survival, progression-free survival, response rate, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 124 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Evidence-based recommendations were developed for patients with multiple myeloma who are transplantation eligible and those who are ineligible and for patients with relapsed or refractory disease.

scholarly journals One Size Does Not Fit All: A Comprehensive Clinical Approach to Reducing Suicidal Ideation, Attempts, and Deaths

2019 ◽  
Vol 16 (19) ◽  
pp. 3606 ◽  
Author(s):  
David A. Jobes ◽  
Samantha A. Chalker
Keyword(s):  
Mentally Ill ◽  
Health Management ◽  
Clinical Care ◽  
Cost Effective ◽  
Evidence Base ◽  
Stepped Care ◽  
Clinical Approach ◽  
Evidence Based ◽  
Suicidal Risk ◽  
The One

While the existence of mental illness has been documented for centuries, the understanding and treatment of such illnesses has evolved considerably over time. Ritual exorcisms and locking mentally ill patients in asylums have been fundamentally replaced by the use of psychotropic medications and evidence-based psychological practices. Yet the historic roots of mental health management and care has left a certain legacy. With regard to suicidal risk, the authors argue that suicidal patients are by definition seen as mentally ill and out of control, which demands hospitalization and the treatment of the mental disorder (often using a medication-only approach). Notably, however, the evidence for inpatient care and a medication-only approach for suicidal risk is either limited or totally lacking. Thus, the “one-size-fits-all” approach to treating suicidal risk needs to be re-considered in lieu of the evolving evidence base. To this end, the authors highlight a series of evidence-based considerations for suicide-focused clinical care, culminating in a stepped care public health model for optimal clinical of suicidal risk that is cost-effective, least-restrictive, and evidence-based.

scholarly journals Framing a Vision for Physiotherapy Research: Synthesizing Educators' Viewpoints in Cape Town

2007 ◽  
Author(s):  
Quinette louw ◽  
Karen Grimmer-Somers ◽  
Lynette Crous ◽  
Margaret Marais ◽  
Seyi Amosum
Keyword(s):  
South Africa ◽  
Clinical Practice ◽  
South African ◽  
Clinical Teaching ◽  
Cape Town ◽  
Evidence Base ◽  
Future Research ◽  
Evidence Based ◽  
Structured Interviews ◽  
Research Education

Purpose: The Cape Town region is the largest training locality for physiotherapy training in South Africa. The socio-political changes since the first democratic election in South Africa have impacted on physiotherapy training and clinical practice, although there currently is no evidence-based vision statement for physiotherapy practice in South Africa. This paper reports key findings from interviews held with three prominent physiotherapy educators / administrators in the three Cape Town universities' physiotherapy schools regarding their perspectives on research, clinical teaching and evidence-based practice in physiotherapy. The purpose of this research was to frame a vision for South African physiotherapy, which could underpin profession-wide discussions on equity, accessibility, safety, evidence-base and appropriate-resourced physiotherapy care for all South Africans. Method: A qualitative research design was employed and semi-structured interviews were conducted individually with 3 key participants who each have more than 10 years experience in education at the three physiotherapy tertiary training institutions in Cape Town. The questions sought perspectives on where physiotherapy research education had come from over recent times in South Africa, what contributed to its successes and failures, and what future there was for research and clinical practice in South Africa into the future. Results: The positive points about South African research were that research interest is perceived to be growing for academics and clinicians, postgraduate degrees have been introduced in all Cape Town universities. Negative points were reported included a lack of focus and direction for research and the overwhelming volume of research to be undertaken relative to the changing South African health care scene. Conclusion: The research findings highlight the need for the development of a vision that rises above individual organizations and institutions, and which takes a nation-wide view of future research and its relationship with clinical practice and community need.

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